Maui Memorial Medical Center and other local emergency-service providers use simulations to prepare their staffs for a mass casualty disaster, according to an article on the Hawaii Business website.

A 2015 report by the U.S. Office of Emergency Management praised the state for its high level of cooperation and communication among agencies and hospitals to plan and prepare for emergencies, and for developing a reserve of emergency supplies and equipment distributed across all islands.

But the organization that has taken the lead in coordinating those efforts, the Healthcare Association of Hawaii, is coping with funding cuts that could jeopardize its programs.

The issue is compounded by the state’s regulatory environment, which seeks to create an economically sustainable healthcare system by limiting the growth of facilities through a certificate-of-need process. Because of this, there’s no excess bed capacity.

Read the article.